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Erythroblastosis fetalis

This figure shows an umbilical artery and vein passing through the placenta on the top left. The top right panel shows the first exposure to Rh+ antibodies in the mother. The bottom right panel shows the response when the second exposure in the form of another fetus takes place. Textboxes detail the steps in each process.
The first exposure of an Rh mother to Rh + erythrocytes during pregnancy induces sensitization. Anti-Rh antibodies begin to circulate in the mother’s bloodstream. A second exposure occurs with a subsequent pregnancy with an Rh + fetus in the uterus. Maternal anti-Rh antibodies may cross the placenta and enter the fetal bloodstream, causing agglutination and hemolysis of fetal erythrocytes.

A drug known as RhoGAM, short for Rh immune globulin, can temporarily prevent the development of Rh antibodies in the Rh mother, thereby averting this potentially serious disease for the fetus. RhoGAM antibodies destroy any fetal Rh + erythrocytes that may cross the placental barrier. RhoGAM is normally administered to Rh mothers during weeks 26−28 of pregnancy and within 72 hours following birth. It has proven remarkably effective in decreasing the incidence of HDN. Earlier we noted that the incidence of HDN in an Rh + subsequent pregnancy to an Rh mother is about 13–14 percent without preventive treatment. Since the introduction of RhoGAM in 1968, the incidence has dropped to about 0.1 percent in the United States.

Determining abo blood types

Clinicians are able to determine a patient’s blood type quickly and easily using commercially prepared antibodies. An unknown blood sample is allocated into separate wells. Into one well a small amount of anti-A antibody is added, and to another a small amount of anti-B antibody. If the antigen is present, the antibodies will cause visible agglutination of the cells ( [link] ). The blood should also be tested for Rh antibodies.

Cross matching blood types

This figure shows three different red blood cells with different blood types.
This sample of a commercially produced “bedside” card enables quick typing of both a recipient’s and donor’s blood before transfusion. The card contains three reaction sites or wells. One is coated with an anti-A antibody, one with an anti-B antibody, and one with an anti-D antibody (tests for the presence of Rh factor D). Mixing a drop of blood and saline into each well enables the blood to interact with a preparation of type-specific antibodies, also called anti-seras. Agglutination of RBCs in a given site indicates a positive identification of the blood antigens, in this case A and Rh antigens for blood type A + . For the purpose of transfusion, the donor’s and recipient’s blood types must match.

Abo transfusion protocols

To avoid transfusion reactions, it is best to transfuse only matching blood types; that is, a type B + recipient should ideally receive blood only from a type B + donor and so on. That said, in emergency situations, when acute hemorrhage threatens the patient’s life, there may not be time for cross matching to identify blood type. In these cases, blood from a universal donor    —an individual with type O blood—may be transfused. Recall that type O erythrocytes do not display A or B antigens. Thus, anti-A or anti-B antibodies that might be circulating in the patient’s blood plasma will not encounter any erythrocyte surface antigens on the donated blood and therefore will not be provoked into a response. One problem with this designation of universal donor is if the O individual had prior exposure to Rh antigen, Rh antibodies may be present in the donated blood. Also, introducing type O blood into an individual with type A, B, or AB blood will nevertheless introduce antibodies against both A and B antigens, as these are always circulating in the type O blood plasma. This may cause problems for the recipient, but because the volume of blood transfused is much lower than the volume of the patient’s own blood, the adverse effects of the relatively few infused plasma antibodies are typically limited. Rh factor also plays a role. If Rh individuals receiving blood have had prior exposure to Rh antigen, antibodies for this antigen may be present in the blood and trigger agglutination to some degree. Although it is always preferable to cross match a patient’s blood before transfusing, in a true life-threatening emergency situation, this is not always possible, and these procedures may be implemented.

A patient with blood type AB + is known as the universal recipient    . This patient can theoretically receive any type of blood, because the patient’s own blood—having both A and B antigens on the erythrocyte surface—does not produce anti-A or anti-B antibodies. In addition, an Rh + patient can receive both Rh + and Rh blood. However, keep in mind that the donor’s blood will contain circulating antibodies, again with possible negative implications. [link] summarizes the blood types and compatibilities.

At the scene of multiple-vehicle accidents, military engagements, and natural or human-caused disasters, many victims may suffer simultaneously from acute hemorrhage, yet type O blood may not be immediately available. In these circumstances, medics may at least try to replace some of the volume of blood that has been lost. This is done by intravenous administration of a saline solution that provides fluids and electrolytes in proportions equivalent to those of normal blood plasma. Research is ongoing to develop a safe and effective artificial blood that would carry out the oxygen-carrying function of blood without the RBCs, enabling transfusions in the field without concern for incompatibility. These blood substitutes normally contain hemoglobin- as well as perfluorocarbon-based oxygen carriers.

Abo blood group

This table shows the different blood types, the antibodies in plasma, the antigens in the red blood cell, and the blood compatible blood types in an emergency.
This chart summarizes the characteristics of the blood types in the ABO blood group. See the text for more on the concept of a universal donor or recipient.

Chapter review

Antigens are nonself molecules, usually large proteins, which provoke an immune response. In transfusion reactions, antibodies attach to antigens on the surfaces of erythrocytes and cause agglutination and hemolysis. ABO blood group antigens are designated A and B. People with type A blood have A antigens on their erythrocytes, whereas those with type B blood have B antigens. Those with AB blood have both A and B antigens, and those with type O blood have neither A nor B antigens. The blood plasma contains preformed antibodies against the antigens not present on a person’s erythrocytes.

A second group of blood antigens is the Rh group, the most important of which is Rh D. People with Rh blood do not have this antigen on their erythrocytes, whereas those who are Rh + do. About 85 percent of Americans are Rh + . When a woman who is Rh becomes pregnant with an Rh + fetus, her body may begin to produce anti-Rh antibodies. If she subsequently becomes pregnant with a second Rh + fetus and is not treated preventively with RhoGAM, the fetus will be at risk for an antigen-antibody reaction, including agglutination and hemolysis. This is known as hemolytic disease of the newborn.

Cross matching to determine blood type is necessary before transfusing blood, unless the patient is experiencing hemorrhage that is an immediate threat to life, in which case type O blood may be transfused.

References

American Red Cross (US). Blood types [Internet]. c2013 [cited 2013 Apr 3]. Available from: (External Link) 2013

Questions & Answers

yellow marrow has been identified as
Raychelle Reply
Which of the following accurately describe external resipration
Gwendolyn Reply
from the heart to the lungs
Phee
I think it's not outside organ of respiratory all respiratory organ are inside of human body
Moha
diffusion of CO2 and oxygen at a pulmonary capillary surrounding an alveolar sac.
Jeremiah
In other words, from the external environment to the lungs (alveoli) then to the pulmonary capillary then to the heart. So this is a stage of inhalation. inhale = external respiration.
Jeremiah
What kind of discussion
horyaal Reply
what is the function of the placenta
Nchimunya Reply
The placenta acts to provide oxygen and nutrientsto the fetus, whilst removing carbon dioxide and other waste products.
Moha
Also it's the barrier through which the mother is connected to the fetus.
Samuel
I want to discuss... atherosclerosis.., everything about it, about to treatment n prevention at age 50 +
Doctors
Please participate in discussion
Doctors
ok let's discuss now
Moha
first define the word artherosclerosis
Moha
a disease of the arteries characterized by the deposition of fatty material on their inner walls.
tabe
hardening of the arteries, due to fats..
jenelyn
Q = which type of fat utilized for this.., I.e LDL, HDL, TG, VLDL...?
Doctors
Atherosclerosis is a condition of deposition of plaque inside the artries
Arvind
Plaque include such as fat, chalestrol, calcium etc
Arvind
Thank you kumar...., is there any way that we can protect these plaques without any medicines., I. e exercises n food stuffs
Doctors
go to the gym
Moha
what is chylomicrons?
Moha
how can plaque buildup in The angina or vessels ?
Moha
Atherosclerosis is a condition of deposition of plaque inside the artries
Doctors
atherosclerosis can also be caused by tortuousness of arteries with old age as contributing factor.
edward
You tube Prof Fink...he is an amazing lecturer and does a brilliant job on arteriosclerosis
Jacqueline
what are cell
Chigozie Reply
The basic structural and functional unit of any living thing. Each cell is a small container of chemicals and water wrapped in a membrane. 
Yusuf
cell is the structural and functional basic unit of life
Zaid
So every living thing was Created From a Cell
Anthony
from a fusion of two cells , the sperm and the egg
Shikoh
What is the only bone that doesn't have any articulation?
Jimmy
that magical fusion of cells
OBED
why body immune system attack and destroy the body own cell during type 1 diabetes?
Sanamacha Reply
It's an autoimmune disease... targeting the pancreas
Claudia
what are the three genetic defects of pregnancy?
Belinda Reply
structure of fallopian tubes
Akash Reply
what z the role played by the transport system
zinitha Reply
how fats are digested in the human body
Nabukwasi Reply
Fat digestion begins in the stomach but some argue in that it starts in the mouth. Reason is because the sublingual gland secretes an enzyme called lingual lipase. However, this enzyme is not activated until it comes into contact with gastric fluids (HCl). In the stomach, HCl breaks down the lipid..
Jeremiah
due to body heat
Mule
into smaller molecules. Going from a triglyceride and a fatty acid to a monoglyceride and a a fatty acid no longer bound to one another. This is known as lipolysis.
Jeremiah
After lipolysis in the stomach from gastric and lingual lipase, an acidic chyme is produced after stomach churning the bolus. The chyme exits the stomach at the pyloric sphincter and enters the first section of the small intestine known as the duodenum.
Jeremiah
in the duodenum. An alkaline mucus from goblet cells neutralizes the acidic chyme to prevent acid burns. After that, the pancreas and gallbladder secrete a number of enzymes to continue lipolysis. Bile from the gallbladder enters the duodenum via common bile duct. The acinar cells in the pancreas...
Jeremiah
secretes pancreatic lipase after enteroendocrine cells in the duodenum secrete a stimulator hormone called CCK. Cck stimulates bile synthesis and secretion as well as pancreatic lipase.
Jeremiah
Bile emuslifies the lipid, allowing the lipases to continue lipolysis
Jeremiah
this breakdown continues until it reaches the jejunum of the small intestines. At this point, the lipid has been broken down small enough to absorbed into the blood stream. So villi in the jejunum, absorb the contents.
Jeremiah
ileum, the last small intestine region, absorbs anything that wasn't absorbed previously. Like minerals, vitamins, bile salts, water soluble material. Villi here complete that task. Fatty acid and glycerol however, are absorbed by lacteals. small lymph vessels. And are transported to the liver.
Jeremiah
That concludes lipid digestion. Anything else that remains is deficated after it travels through the large intestines.
Jeremiah
parents with blood group AB & 0,,,what will b the blood group of their offspring
imran
what are the different branches of anatomy
Nabukwasi
hopefully that helped.
Jeremiah
which ion is low of blood level?
Ezra Reply
what is coagulation?
feng Reply
liquid turning to solid... blood clots.
Kristy
coagulation : liquid blood into blood clots caused with a coagulant.
jaime
when the blood turn from liquid form to solid
June
it said to coagulate by the action of active plasma protein called *fibrin*
Hassan
I.e liquid inform of blood when to solid
Hassan
it is the process by which blood becomes more viscous or becomes thick
CHRISTOPHER
cloting of blood cells
Kabange
clot of blood
Moses
the process of forming semi solid lumps in a liquid
rida
conversion of blood to solid state
Ezra
semi solid., rather than solid form
Doctors
what is pivot functioned
Ever
to less thefriction
Hirsi
how to calculate the micrograph
Ampong Reply
it can be used to knw the disease condition
Akbar Reply
which gland secret tears
Opoku
lacrimal glands
Diego
explain the blood supply to the brain
Brenda Reply
There are two paired arteries which are responsible for the blood supply to the brain; the vertebral arteries, and the internal carotid arteries. These arteries arise in the neck, and ascend to the cranium.
Sabrina
two arteries main vertebral arteries & internal carotid artery
Akbar

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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